Skip to main content
Top
Published in: BMC Oral Health 1/2016

Open Access 01-12-2016 | Research article

Caries remineralisation and arresting effect in children by professionally applied fluoride treatment – a systematic review

Authors: Sherry Shiqian Gao, Shinan Zhang, May Lei Mei, Edward Chin-Man Lo, Chun-Hung Chu

Published in: BMC Oral Health | Issue 1/2016

Login to get access

Abstract

Background

As a low-cost and easily operated treatment, the use of professionally applied topical fluoride was approved for preventing dental caries and remineralising early enamel caries or white spot lesions. It is also used to arrest dentine caries. The aim of this study is to investigate the clinical efficacy of professional fluoride therapy in remineralising and arresting caries in children.

Method

A systematic search of publications from 1948 to 2014 was conducted using four databases: PubMed, Cochrane Library, ISI Web of Science and Embase. The key words used were (fluoride) AND (remineralisation OR remineralization OR arresting) AND (children caries OR early childhood caries). The title and abstract of initially identified publications were screened. Clinical trials about home-use fluorides, laboratory studies, case reports, reviews, non-English articles and irrelevant studies were excluded. The full texts of the remaining papers were retrieved. Manual screening was conducted on the bibliographies of the remaining papers to identify relevant articles.

Results

A total of 2177 papers were found, and 17 randomised clinical trials were included in this review. Ten studies investigated the remineralising effect on early enamel caries using silicon tetrafluoride, fluoride gel, silver diamine fluoride or sodium fluoride. Seven studies reported an arresting effect on dentine caries using silver diamine fluoride or nano-silver fluoride. Meta-analysis was performed on four papers using 5 % sodium fluoride varnish to remineralise early enamel caries, and the overall percentage of remineralised enamel caries was 63.6 % (95 % CI: 36.0 % - 91.2 %; p < 0.001). Meta-analysis was also performed on five papers using 38 % silver diamine fluoride to arrest dentine caries and the overall proportion of arrested dentine caries was 65.9 % (95 % CI: 41.2 % - 90.7 %; p < 0.001).

Conclusion

Professionally applied 5 % sodium fluoride varnish can remineralise early enamel caries and 38 % silver diamine fluoride is effective in arresting dentine caries.
Literature
1.
go back to reference Dye BA, Tan S, Smith V, Lewis B, Barker L, Thornton-Evans G, et al. Trends in oral health status: United States, 1988-1994 and 1999-2004. Vital and health statistics. Series 11, Data from the national health survey, 2007(248):1-92. Dye BA, Tan S, Smith V, Lewis B, Barker L, Thornton-Evans G, et al. Trends in oral health status: United States, 1988-1994 and 1999-2004. Vital and health statistics. Series 11, Data from the national health survey, 2007(248):1-92.
2.
go back to reference Bagramian RA, Garcia-Godoy F, Volpe AR. The global increase in dental caries. A pending public health crisis. Am J Dent. 2009;22(1):3–8.PubMed Bagramian RA, Garcia-Godoy F, Volpe AR. The global increase in dental caries. A pending public health crisis. Am J Dent. 2009;22(1):3–8.PubMed
3.
go back to reference Chu C, Fung D, Lo E. Dental public health: dental caries status of preschool children in Hong Kong. Br Dent J. 1999;187(11):616–20.PubMed Chu C, Fung D, Lo E. Dental public health: dental caries status of preschool children in Hong Kong. Br Dent J. 1999;187(11):616–20.PubMed
5.
go back to reference Chu C, Lo E. Promoting caries arrest in children with silver diamine fluoride: a review. Oral Health Prev Dent. 2008;6(4):315–21.PubMed Chu C, Lo E. Promoting caries arrest in children with silver diamine fluoride: a review. Oral Health Prev Dent. 2008;6(4):315–21.PubMed
6.
go back to reference Rajab LD, Hamdan M. Early childhood caries and risk factors in Jordan. Community Dent Health. 2002;19(4):224–9.PubMed Rajab LD, Hamdan M. Early childhood caries and risk factors in Jordan. Community Dent Health. 2002;19(4):224–9.PubMed
7.
go back to reference Chu C, Mei ML, Lo E. Use of fluorides in dental caries management. Gen Dent. 2009, 58(1):37-43; quiz 44-35, 79-80. Chu C, Mei ML, Lo E. Use of fluorides in dental caries management. Gen Dent. 2009, 58(1):37-43; quiz 44-35, 79-80.
8.
go back to reference Mei ML, Chu CH, Low KH, Che CM, Lo EC. Caries arresting effect of silver diamine fluoride on dentine carious lesion with S. mutans and L. acidophilus dual-species cariogenic biofilm. Med Oral Patol Oral Cir Bucal. 2013;18(6):e824.PubMedCentralCrossRefPubMed Mei ML, Chu CH, Low KH, Che CM, Lo EC. Caries arresting effect of silver diamine fluoride on dentine carious lesion with S. mutans and L. acidophilus dual-species cariogenic biofilm. Med Oral Patol Oral Cir Bucal. 2013;18(6):e824.PubMedCentralCrossRefPubMed
9.
go back to reference Divaris K, Preisser J, Slade G. Surface-specific efficacy of fluoride varnish in caries prevention in the primary dentition: results of a community randomized clinical trial. Caries Res. 2012;47(1):78–87.CrossRefPubMed Divaris K, Preisser J, Slade G. Surface-specific efficacy of fluoride varnish in caries prevention in the primary dentition: results of a community randomized clinical trial. Caries Res. 2012;47(1):78–87.CrossRefPubMed
10.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.CrossRefPubMed Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.CrossRefPubMed
11.
go back to reference Lo E, Chu C, Lin H. A community-based caries control program for pre-school children using topical fluorides: 18-month results. J Dent Res. 2001;80(12):2071–4.CrossRefPubMed Lo E, Chu C, Lin H. A community-based caries control program for pre-school children using topical fluorides: 18-month results. J Dent Res. 2001;80(12):2071–4.CrossRefPubMed
12.
go back to reference Chu C, Lo E, Lin H. Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children. J Dent Res. 2002;81(11):767–70.CrossRefPubMed Chu C, Lo E, Lin H. Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children. J Dent Res. 2002;81(11):767–70.CrossRefPubMed
13.
go back to reference Llodra J, Rodriguez A, Ferrer B, Menardia V, Ramos T, Morato M. Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren: 36-month clinical trial. J Dent Res. 2005;84(8):721–4.CrossRefPubMed Llodra J, Rodriguez A, Ferrer B, Menardia V, Ramos T, Morato M. Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren: 36-month clinical trial. J Dent Res. 2005;84(8):721–4.CrossRefPubMed
14.
go back to reference Zhi QH, Lo ECM, Lin HC. Randomized clinical trial on effectiveness of silver diamine fluoride and glass ionomer in arresting dentine caries in preschool children. J Dent. 2012;40(11):962–7.CrossRefPubMed Zhi QH, Lo ECM, Lin HC. Randomized clinical trial on effectiveness of silver diamine fluoride and glass ionomer in arresting dentine caries in preschool children. J Dent. 2012;40(11):962–7.CrossRefPubMed
15.
go back to reference Yee R, Holmgren C, Mulder J, Lama D, Walker D, van Palenstein HW. Efficacy of silver diamine fluoride for arresting caries treatment. J Dent Res. 2009;88(7):644–7.CrossRefPubMed Yee R, Holmgren C, Mulder J, Lama D, Walker D, van Palenstein HW. Efficacy of silver diamine fluoride for arresting caries treatment. J Dent Res. 2009;88(7):644–7.CrossRefPubMed
16.
go back to reference dos Santos VE, de Vasconcelos F, Ribeiro AG, Rosenblatt A. Paradigm shift in the effective treatment of caries in schoolchildren at risk. Int Dent J. 2012;62(1):47–51.CrossRefPubMed dos Santos VE, de Vasconcelos F, Ribeiro AG, Rosenblatt A. Paradigm shift in the effective treatment of caries in schoolchildren at risk. Int Dent J. 2012;62(1):47–51.CrossRefPubMed
17.
go back to reference dos Santos VE, Vasconcelos Filho A, Targino AGR, Flores MAP, Galembeck A, Caldas AF, et al. A new “Silver-Bullet” to treat caries in children–Nano Silver Fluoride: a randomised clinical trial. J Dent. 2014;42(8):945–51.CrossRefPubMed dos Santos VE, Vasconcelos Filho A, Targino AGR, Flores MAP, Galembeck A, Caldas AF, et al. A new “Silver-Bullet” to treat caries in children–Nano Silver Fluoride: a randomised clinical trial. J Dent. 2014;42(8):945–51.CrossRefPubMed
18.
go back to reference Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions, vol. 5: Wiley Online Library; 2008. Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions, vol. 5: Wiley Online Library; 2008.
19.
go back to reference Tranæus S, Al‐Khateeb S, Björkman S, Twetman S, Angmar‐Månsson B. Application of quantitative light‐induced fluorescence to monitor incipient lesions in caries‐active children. A comparative study of remineralisation by fluoride varnish and professional cleaning. Eur J Oral Sci. 2001;109(2):71–5.CrossRefPubMed Tranæus S, Al‐Khateeb S, Björkman S, Twetman S, Angmar‐Månsson B. Application of quantitative light‐induced fluorescence to monitor incipient lesions in caries‐active children. A comparative study of remineralisation by fluoride varnish and professional cleaning. Eur J Oral Sci. 2001;109(2):71–5.CrossRefPubMed
20.
go back to reference Kukleva MP. Treatment of incipient caries in children with fluoride gel. Folia Med. 2001;44(1-2):50–5. Kukleva MP. Treatment of incipient caries in children with fluoride gel. Folia Med. 2001;44(1-2):50–5.
21.
go back to reference Bonow MLM, Azevedo MS, Goettems ML, Rodrigues CRMD. Efficacy of 1.23 % APF gel applications on incipient carious lesions: a double-blind randomized clinical trial. Braz Oral Res. 2013;27(3):279–85.CrossRefPubMed Bonow MLM, Azevedo MS, Goettems ML, Rodrigues CRMD. Efficacy of 1.23 % APF gel applications on incipient carious lesions: a double-blind randomized clinical trial. Braz Oral Res. 2013;27(3):279–85.CrossRefPubMed
22.
go back to reference Braga M, Mendes F, De Benedetto M, Imparato J. Effect of silver diammine fluoride on incipient caries lesions in erupting permanent first molars: a pilot study. J Dent Child. 2009;76(1):28–33. Braga M, Mendes F, De Benedetto M, Imparato J. Effect of silver diammine fluoride on incipient caries lesions in erupting permanent first molars: a pilot study. J Dent Child. 2009;76(1):28–33.
23.
go back to reference Autio-Gold JT, Courts F. Assessing the effect of fluoride varnish on early enamel carious lesions in the primary dentition. J Am Dent Assoc. 2001;132(9):1247–53.CrossRefPubMed Autio-Gold JT, Courts F. Assessing the effect of fluoride varnish on early enamel carious lesions in the primary dentition. J Am Dent Assoc. 2001;132(9):1247–53.CrossRefPubMed
24.
go back to reference De Amorim RG, Leal SC, BEZERRA ACB, DE AMORIM FPLG, De Toledo OA. Association of chlorhexidine and fluoride for plaque control and white spot lesion remineralization in primary dentition. Int J Paediatr Dent. 2008, 18(6):446-451. De Amorim RG, Leal SC, BEZERRA ACB, DE AMORIM FPLG, De Toledo OA. Association of chlorhexidine and fluoride for plaque control and white spot lesion remineralization in primary dentition. Int J Paediatr Dent. 2008, 18(6):446-451.
25.
go back to reference Xhemnica L, Sulo D, Rroço R, Hysi D. Fluoride varnish application: a new prophylactic method in Albania. Effect on enamel carious lesions in permanent dentition. Eur J Paediatr Dent. 2008;9(2):93–6.PubMed Xhemnica L, Sulo D, Rroço R, Hysi D. Fluoride varnish application: a new prophylactic method in Albania. Effect on enamel carious lesions in permanent dentition. Eur J Paediatr Dent. 2008;9(2):93–6.PubMed
26.
go back to reference Ferreira JMS, Aragão AKR, Rosa ADB, Sampaio FC, Menezes VA. Therapeutic effect of two fluoride varnishes on white spot lesions: a randomized clinical trial. Braz Oral Res. 2009;23(4):446–51.CrossRefPubMed Ferreira JMS, Aragão AKR, Rosa ADB, Sampaio FC, Menezes VA. Therapeutic effect of two fluoride varnishes on white spot lesions: a randomized clinical trial. Braz Oral Res. 2009;23(4):446–51.CrossRefPubMed
27.
go back to reference Almeida MQ, Costa OXI, Ferreira JMS, Menezes VA, Leal RB, Sampaio FC. Therapeutic potential of Brazilian fluoride varnishes: an in vivo study. Braz Dent J. 2011;22(3):193–7.PubMed Almeida MQ, Costa OXI, Ferreira JMS, Menezes VA, Leal RB, Sampaio FC. Therapeutic potential of Brazilian fluoride varnishes: an in vivo study. Braz Dent J. 2011;22(3):193–7.PubMed
28.
go back to reference Du M, Cheng N, Tai B, Jiang H, Li J, Bian Z. Randomized controlled trial on fluoride varnish application for treatment of white spot lesion after fixed orthodontic treatment. Clin Oral Investig. 2012;16(2):463–8.CrossRefPubMed Du M, Cheng N, Tai B, Jiang H, Li J, Bian Z. Randomized controlled trial on fluoride varnish application for treatment of white spot lesion after fixed orthodontic treatment. Clin Oral Investig. 2012;16(2):463–8.CrossRefPubMed
29.
go back to reference Marinho VCC, Worthington HV, Walsh T, Clarkson JE. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2013, Issue 7. Art. No.: CD002279. DOI: 10.1002/14651858.CD002279.pub2. Marinho VCC, Worthington HV, Walsh T, Clarkson JE. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2013, Issue 7. Art. No.: CD002279. DOI: 10.​1002/​14651858.​CD002279.​pub2.
30.
go back to reference Marinho VCC, Worthington HV, Walsh T, Chong LY. Fluoride gels for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2015, Issue 6. Art. No.: CD002280. DOI: 10.1002/14651858.CD002280.pub2. Marinho VCC, Worthington HV, Walsh T, Chong LY. Fluoride gels for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2015, Issue 6. Art. No.: CD002280. DOI: 10.​1002/​14651858.​CD002280.​pub2.
31.
32.
go back to reference Chan A-W, Tetzlaff JM, Altman DG, Laupacis A, Gà PC, Krleža-JeriÄ K. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–7.CrossRefPubMed Chan A-W, Tetzlaff JM, Altman DG, Laupacis A, Gà PC, Krleža-JeriÄ K. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–7.CrossRefPubMed
33.
go back to reference Chu CH, Mei L, Seneviratne CJ, Lo ECM. Effects of silver diamine fluoride on dentine carious lesions induced by Streptococcus mutans and Actinomyces naeslundii biofilms. Int J Paediatr Dent. 2012;22(1):2–10.CrossRefPubMed Chu CH, Mei L, Seneviratne CJ, Lo ECM. Effects of silver diamine fluoride on dentine carious lesions induced by Streptococcus mutans and Actinomyces naeslundii biofilms. Int J Paediatr Dent. 2012;22(1):2–10.CrossRefPubMed
34.
go back to reference Wong AW, Zhang C, Chu C-h. A systematic review of nonsurgical single-visit versus multiple-visit endodontic treatment. Clin Cosmet Investig Dent. 2014;6:45.PubMedCentralPubMed Wong AW, Zhang C, Chu C-h. A systematic review of nonsurgical single-visit versus multiple-visit endodontic treatment. Clin Cosmet Investig Dent. 2014;6:45.PubMedCentralPubMed
35.
36.
go back to reference Chu C, Lo E. A review of sodium fluoride varnish. Gen Dent. 2005;54(4):247–53. Chu C, Lo E. A review of sodium fluoride varnish. Gen Dent. 2005;54(4):247–53.
37.
go back to reference Petersen PE, Lennon MA. Effective use of fluorides for the prevention of dental caries in the 21st century: the WHO approach. Community Dent Oral Epidemiol. 2004;32(5):319–21.CrossRefPubMed Petersen PE, Lennon MA. Effective use of fluorides for the prevention of dental caries in the 21st century: the WHO approach. Community Dent Oral Epidemiol. 2004;32(5):319–21.CrossRefPubMed
38.
go back to reference Mei ML, Ito L, Cao Y, Li Q, Lo E, Chu C. Inhibitory effect of silver diamine fluoride on dentine demineralisation and collagen degradation. J Dent. 2013;41(9):809–17.CrossRefPubMed Mei ML, Ito L, Cao Y, Li Q, Lo E, Chu C. Inhibitory effect of silver diamine fluoride on dentine demineralisation and collagen degradation. J Dent. 2013;41(9):809–17.CrossRefPubMed
39.
go back to reference Mei ML, Chu CH, Lo ECM, Samaranayake LP. Fluoride and silver concentrations of silver diammine fluoride solutions for dental use. Int J Paediatr Dent. 2013;23(4):279–85.CrossRefPubMed Mei ML, Chu CH, Lo ECM, Samaranayake LP. Fluoride and silver concentrations of silver diammine fluoride solutions for dental use. Int J Paediatr Dent. 2013;23(4):279–85.CrossRefPubMed
40.
go back to reference Rosenblatt A, Stamford T, Niederman R. Silver diamine fluoride: a caries “silver-fluoride bullet”. J Dent Res. 2009;88(2):116–25.CrossRefPubMed Rosenblatt A, Stamford T, Niederman R. Silver diamine fluoride: a caries “silver-fluoride bullet”. J Dent Res. 2009;88(2):116–25.CrossRefPubMed
Metadata
Title
Caries remineralisation and arresting effect in children by professionally applied fluoride treatment – a systematic review
Authors
Sherry Shiqian Gao
Shinan Zhang
May Lei Mei
Edward Chin-Man Lo
Chun-Hung Chu
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2016
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-016-0171-6

Other articles of this Issue 1/2016

BMC Oral Health 1/2016 Go to the issue